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More Diagnostic Testing: The MMPI, the MCMI, and MMSE

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The Minnesota Multiphasic Personality Inventory-2 ... Histrionic. Narcissistic. Antisocial. Aggressive. Compulsive. Passive Aggressive. Self-Defeating ... – PowerPoint PPT presentation

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Title: More Diagnostic Testing: The MMPI, the MCMI, and MMSE


1
More Diagnostic TestingThe MMPI, the MCMI, and
MMSE
  • PSY 614
  • Instructor Emily E. Bullock, Ph.D.

2
DSM-IV-TR Diagnosis
  • Axis I-Clinical Disorders
  • Axis II-Personality Disorders Mental Retardation
  • Axis II-General Medical Conditions
  • Axis IV-Psychosocial Environmental Problems
  • Axis V-Global Assessment of Functioning Scale
    (GAF)

3
The MMPI-2
  • The Minnesota Multiphasic Personality Inventory-2
  • Standardized questionnaire that elicits a wide
    range of self-descriptions scored to give a
    quantitative measurement of an individuals level
    of emotional adjustment and attitude toward test
    taking
  • Most widely used clinical inventory and has over
    10,000 published research references
  • Original development of MMPI-1939 at the Univ. of
    Minnesota by Hathaway and McKinley
  • MMPI revised to create MMPI-2 in 1989

4
The MMPI-2The Basics
  • 567 questions
  • 13 Standard Scales (10 of which are
    clinical/personality scales)
  • Other Scales Content, Harris-Lingoes subscales,
    critical items, supplementary scales
  • Requires about 90 minutes to complete
  • MMPI-2 for individuals 18 and over 8th grade
    reading level
  • MMPI-A for adolescents 14-18

5
The MMPIPsychometric Properties
  • Reliability Complex due to of scales and
    different populations sampled
  • Temporal stability and Internal Consistency
    .71-.84
  • Split Half .05-.96 (.70 median)
  • Test-Retest .58-.92
  • Validity
  • Normative Group 1,138 males 1,462 females from
    7 states

6
MMPI-2Scaling and Scoring
  • Type of scaling used original pool of questions
    developed theoretically final question pool
    determined empirically
  • Scoring
  • Mean50 Standard Deviation10
  • Clinical significance T score of 65 (92nd
    percentile)
  • Interpretation norm referenced
  • Code types used in interpretation-good
    psychometric qualities

7
MMPI-2 Limitations and Group Issues
  • Provides more reliable information for abnormal
    rather than normal individuals
  • Misleading labels for scales
  • Higher reading level and psychological
    sophistication necessary
  • No consistent patterns have been found across
    different populations for African Americans,
    Native Americans, Hispanics, and Asian Americans
  • Card version for those with concentration issues
  • Audio version for issues of blindness,
    illiteracy, or aphasia

8
MMPI-2The 3 Main/Original Validity Scales
  • L (Lie) scale attempt to which a person is
    attempting to describe himself or herself in an
    unrealistically positive manner
  • F (Infrequency) scale extent to which person
    answers in an atypical and deviant manner
  • K (Correction) scale detects persons describing
    themselves in overly positive terms more subtle
    and effective than L scale

9
MMPI-2Other Important Validity Scales
  • The Cannot Say (?) scale determined by the
    number items left unanswered 30 or more items
    unansweredinvalid
  • VRIN (Variable Response Inconsistency Scale)
    detects inconsistent responding
  • TRIN (True Response Inconsistency Scale) detects
    indiscriminant responding

10
MMPI-2Clinical Scales
  • Scale 1 (Hs, Hypochondriasis)
  • Scale 2 (D, Depression)
  • Scale 3 (Hy, Hysteria)
  • Scale 4 (Pd, Psychopathic Deviate)
  • Scale 5 (Mf, Masculinity-Femininity)

11
MMPI-2Clinical Scales
  • Scale 6 (Pa, Paranoia)
  • Scale 7 (Pt, Psychasthenia)
  • Scale 8 (Sc, Schizophrenia)
  • Scale 9 (Ma, Hypomania)
  • Scale 0 (Si, Social Introversion)

12
MMPI-2Interpretation
  • Determine validity of the profile first
  • Note scores above T65
  • Interpret highest elevations first, moderate
    interpretations on only slightly elevated scales

13
The MCMI-III
  • The Millon Clinical Multiaxial Inventory-III
  • Commonly called the Millon or MCMI
  • Standardized, self-report questionnaire that
    assesses a wide range of information related to a
    clients personality, emotional adjustment, and
    attitude toward test taking. It uniquely focuses
    on personality disorders.
  • Based on Millons theory of personality and the
    DSM-IV
  • Originally developed in 1977 This revision
    1994/1997

14
MCMI-IIIThe Basics
  • 175 items
  • 28 scales
  • 20-30 minutes to complete
  • For 18 yrs and older
  • Only appropriate for those seeking or receiving
    more than a moderate level of mental health
    treatment
  • 8th grade reading level

15
MCMI-IIIPsychometric Properties
  • Overall, well constructed psychometric instrument
  • Reliability
  • Internal Consistency Most Scales above .80
  • Test Retest 5-14 day interval Median .91
  • Validity
  • Correlated with other measures from .59 to .70
  • Normative Sample
  • 1,079 Clinical patients who had come from a
    diversity of backgrounds and treatment settings

16
MCMI-IIIScaling and Scoring
  • Initial item pool theoretically developed
    (Millons theory of personality and DSM-IV
    criteria) and utilized empirical methods to
    determine final item pool and scale structures
  • Scores are reported in Base Rates (BR)
  • BR gt 85-characteristics definitely present
  • BR gt 75-some features present
  • BR pf 35-,median score of nonpsychiatric groups
  • BR of 60-median for psychiatric populations

17
MCMI-IIILimitations and Group Issues
  • Scale overlap and some mixed results with
    diagnostic accuracy when compared to clinicians
    interview and MMPI
  • Criteria for scales vary on whether more related
    to Millons theory or DSM criteria
  • State and Trait issue
  • Frequent revisions make it difficult for research
    to catch up
  • Overdiagnoses and Overpathologizes despite the
    group involved

18
MCMI-IIIScales
  • 5 categories of scales
  • Modifying Indices
  • Clinical Personality Patterns
  • Severe Personality Pathology
  • Clinical Syndromes
  • Severe Syndromes

19
MCMI-IIIModifying Indices
  • Disclosure
  • Debasement
  • Desirability
  • Validity

20
MCMI-IIISevere Personality Pathology Scales
  • Schizotypal
  • Borderline
  • Paranoid

21
MCMI-III Clinical Personality Pattern Scales
  • Schizoid
  • Avoidant
  • Depressive
  • Dependent
  • Histrionic
  • Narcissistic
  • Antisocial
  • Aggressive
  • Compulsive
  • Passive Aggressive
  • Self-Defeating

22
MCMI-IIISevere Syndrome Scales
  • Thought Disorder
  • Major Depression
  • Delusional Disorder

23
MCMI-IIIClinical Syndrome Scales
  • Anxiety
  • Somatoform
  • Bipolar Manic
  • Dysthymia
  • Alcohol Dependence
  • Drug Dependence
  • PTSD

24
MCMI-IIISteps of Interpretation
  • 1. Check validity through the Modifying Indices
  • 2. Interpret the Personality Scales first
  • 3. Interpret Clinical Syndrome Scales
  • 4. Review noteworthy items

25
MMSE
  • Mini-Mental Status Examination
  • Used to assess cognitive mental status as an
    initial evaluation tool or evaluation of
    treatment
  • assesses orientation, attention, immediate and
    short-term recall, language, and the ability to
    follow simple verbal and written commands

26
MMSE
Domains on the Folstein version
  • Orientation to time
  • Orientation to Place
  • Immediate Recall
  • Attention
  • Delayed Recall
  • Naming
  • Repetition
  • 3 Stage Command
  • Reading
  • Copying
  • Writing
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